Causes
The causes that can lead to an ankle fracture are numerous. By far the most common cause of these fractures is the twisting of the foot. Ankle fractures are particularly common in running-intensive sports and skiing.
However, fractures of the ankle joint can also occur when falling on the foot and simultaneously twisting it, as well as in traffic accidents. In most cases, the foot turns inwards and thus creates pressure on the bones of the ankle joint, which they cannot withstand and which causes them to break. This type of injury is medically referred to as supination trauma.
The individual therapy depends on the extent of the injury, the soft tissue impairment, the location of the bone fracture, as well as factors such as the age of the affected person and any previous illnesses. In general, however, it can be said that most ankle fractures are treated with surgery. Only if the bone fragments have not been displaced (dislocated) from one another is conservative therapy and the application of a plaster cast sufficient.
Surgical treatment initially focuses on bringing the bone fragments together in their correct position and fixing the fragments, usually with plates and screws. Depending on the type of fracture and its localization, the therapy can be very complex and sometimes a large number of screws are required to ensure the stability of the bone. If the syndesmosis is also affected, as is often the case with Weber B or Weber C fractures, the joint must also be stabilized with an adjusting screw. In open ankle fractures, it is important to take antibiotics to prevent infection of the wound.
Operation
In most cases an ankle fracture is treated surgically.Depending on the extent of the injury as well as the structures affected, surgery is performed differently. At the beginning of the operation, the attending physician must have access to the affected structures, which is why a skin incision is made. Then the injured structures are exposed and the appropriate fixation in the form of plates, screws or wires is selected.
The surgeon often decides which fixation is suitable in individual cases based on the image presented to him during the operation. If soft tissues are also affected by the injury, the surgeon can weigh up during the operation whether surgical intervention is appropriate for the individual case. For example, ruptured ligaments are sometimes sutured during surgery for an ankle fracture. After the metal fixation has been applied, the surgical wound is sutured and the patient is awakened with the administration of pain medication. It is important that the foot should not be put under stress after the operation in order not to endanger the success of the therapy.